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General NPI Number Information
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NPI Number | 1265602726
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Entity Type | Organization
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Legal Business Name | LAWRENCE D KASSAN
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 2101 SNYDER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19145-2719
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Country | US
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Telephone | 215-336-4151
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Fax | 215-336-5111
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Provider Business Mailing Address
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Address Line | 46 PARTRIDGE LN
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City | CHERRY HILL
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State | NJ
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Zip | 08003-1948
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Country | US
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Telephone | 215-336-4151
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Fax | 215-336-5111
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAWRENCE DREW KASSAN
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Credential | DPM
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Telephone | 215-336-4151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | SC003381L
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License Number State | PA
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